title: Abnormal glucose tolerance: a predictor of 30-day mortality in patients with decompensated liver cirrhosis.
abstract: BACKGROUND
  In liver cirrhosis an abnormal glucose tolerance correlates with a poor long-term prognosis. The aim of this study was to evaluate whether a disturbed glucose metabolism predicts the short-term prognosis in hospitalized patients with decompensated liver cirrhosis.
  
  
  METHODS
  Seventy-eight patients with liver cirrhosis were prospectively enrolled. Disturbed glucose metabolism was determined by a 75-g oral glucose tolerance test (OGTT) according to WHO criteria. Differences in survival were assessed by χ (2) test for 30-day mortality and by multivariate Cox proportional hazards analysis for long-term survival.
  
  
  RESULTS
  Impaired glucose tolerance (IGT) was diagnosed in 29 patients (37 %) and diabetes mellitus (DM) in 26 patients (33 %). A pathological OGTT result was a significant negative predictor of a poor 30-day survival compared to NGT (OR 8.6; p=0.03). DM but not IGT was an independent negative predictor of long-term survival (HR=1.89; p=0.04).
  
  
  CONCLUSIONS
  Disturbed glucose metabolism in hospitalized patients with decompensated liver cirrhosis is correlated with increased 30-day mortality. OGTT appears to be useful for identifying cirrhotic patients with poor short term prognosis.
authors.affiliation: Division of Gastroenterology, Hepatology, and Infectious Diseases, Department of Internal Medicine II, Friedrich-Schiller-University, Jena, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Hagel
authors.forename: T
authors.initials: T
authors.lastname: Bruns
authors.forename: A
authors.initials: A
authors.lastname: Herrmann
authors.forename: A
authors.initials: A
authors.lastname: Stallmach
authors.forename: C
authors.initials: C
authors.lastname: Schmidt
mesh_terms: D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate